Search results for: hyper infarction or post stroke region

Authors: Li Chin Law, Epaminondas Mastorakos, Mohd Roslee Othman, Antonis Trakakis

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The paper introduces an alternative concept of carbon capture for shipping by using pre-combustion carbon capture technology (Pre-CCS), which was proven to be less energy intensive than post-combustion carbon capture from the engine exhaust. Energy assessment on amine-based post-combustion CCS on LNG-fuelled ships showed that the energy efficiency of CCS ships reduced from 48% to 36.6%. Then, an energy assessment was carried out to compare the power and heat requirements of the most used hydrogen production methods and carbon capture technologies. Steam methane reformer (SMR) was found to be 20% more energy efficient and achieved a higher methane conversion than auto thermal reaction and methane decomposition. Next, pressure swing adsorber (PSA) has shown a lower energy requirement than membrane separation, cryogenic separation, and amine absorption in pre-combustion carbon capture. Hence, an integrated system combining SMR and PSA (SMR-PSA) with waste heat integration (WHR) was proposed. This optimized SMR-based integrated system has achieved 65% of CO₂ reduction with less than 7-percentage point of energy penalty (41.7% of energy efficiency). Further integration of post-combustion CCS with the SMR-PSA integrated system improved carbon capture rate to 86.3% with 9-percentage points of energy penalty (39% energy efficiency). The proposed system was shown to be able to meet the carbon reduction targets set by International Maritime Organization (IMO) with certain energy penalties.

Keywords: shipping, decarbonisation, alternative fuels, low carbon, hydrogen, carbon capture

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Authors: Chun-Ying Lee, Kun-Hsien Lee, Bor-Wei Wang

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The process of post-supercritical CO₂ electroplating uses the electrolyte solution after being mixed with supercritical CO₂ and released to atmospheric pressure. It utilizes the microbubbles that form when oversaturated CO₂ in the electrolyte returns to gaseous state, which gives the similar effect of pulsed electroplating. Under atmospheric pressure, the CO₂ bubbles gradually diffuse. Therefore, the introduction of ultrasound and/or other agitation can potentially excite the CO₂ microbubbles to achieve an electroplated surface of even higher quality. In this study, during the electroplating process, three different modes of agitation: magnetic stirrer agitation, ultrasonic agitation and a combined mode (magnetic + ultrasonic) were applied, respectively, in order to obtain an optimal surface morphology and mechanical properties for the electroplated Ni coating. It is found that the combined agitation mode at a current density of 40 A/dm² achieved the smallest grain size, lower surface roughness, and produced an electroplated Ni layer that achieved hardness of 320 HV, much higher when compared with conventional method, which were usually in the range of 160 to 300 HV. However, at the same time, the electroplating with combined agitation developed a higher internal stress of 320 MPa due to the lower current efficiency of the process and finer grain in the coating. Moreover, a new control methodology for tailoring the coating’s mechanical property through its thickness was demonstrated by the timely introduction of ultrasonic agitation during the electroplating process with post supercritical CO₂ mixed electrolyte.

Keywords: nickel electroplating, micro-bubbles, supercritical carbon dioxide, ultrasonic agitation

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Authors: Amr Hamdy

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Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate. Methods: This case series study was conducted in one centre in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant–women aged 18 years or more and candidate for normal labour; were enrolled to this study. High-risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 seconds. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 hours. Results: The rate of PPH, defined as more than 500 ml, was 8 cases (2%) with 95% CI (0.63-3.37%). The rate of PPH was not affected by parity, gestational age, episiotomy or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p <0.001). The range of estimated blood loss was 550-600ml in cases with PPH and 150-450ml in cases without PPH. Severe PPH more than 1000 ml, did not occur. Conclusion: This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of post partum blood loss.Despite the low rate of PPH showed in this study, the need for conducting a randomized controlled study is at its highest level before further inclusion of such manoeuvre to be a part of the current medical practice and before considering it as an evident tool to decrease the burden of PPH.

Keywords: maternal mortality, new manoeuvre, post-partum haemorrhage, uterine atony

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Authors: Luan Vardari, Dena Arapi-Vardari

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Financial stability is a critical component of economic growth and development, and it has been recognized as a key policy objective in many countries around the world. In the Western Balkans, financial stability has been a key issue in recent years, with a number of challenges facing the region, including high levels of public debt, weak banking systems, and economic volatility. Corporate finance, which refers to the financial management practices of firms, is an important factor that can impact financial stability. This paper aims to investigate corporate finance's impact on financial stability in Western Balkan countries. This study will use a mixed-methods approach to investigate the impact of corporate finance on financial stability in the Western Balkans. The study will begin with a comprehensive review of the existing literature on corporate finance and financial stability, focusing on the Western Balkan region. This will be followed by an empirical analysis of regional corporate finance practices using data from various industries and firms. The analysis will explore the relationship between corporate finance practices and financial stability, taking into account factors such as regulatory frameworks, economic conditions, and firm size. The results of the study are expected to provide insights into the impact of corporate finance on financial stability in the Western Balkans. Specifically, the study will identify the key corporate finance practices that contribute to financial stability in the region, as well as the challenges and obstacles that firms face in implementing effective corporate finance strategies. The study will also provide recommendations for policymakers and firms looking to enhance financial stability and resilience in the region.

Keywords: financial regulation, debt management, investment decisions, dividend policies, economic volatility, banking systems, public debt, prudent financial management, firm size, policy recommendations

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Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Chemical peeling is a popular, relatively inexpensive day procedure and generally safe method for treatment of pigmentary skin disorders and for skin rejuvenation. Chemical peels are classified by the depth of action into superficial, medium, and deep peels.Various facial pigmentary conditions have significant impact on quality of life causing psychological stress, necessitating its safe and effective treatment.Aim & Objectives:To compare the efficacy of Salicylic acid, Trichloroaceticacid & Glycolic Acid in facial melanosis(melasma,photomelanosis& post acne pigmentation).To study the side effects of above mentioned peeling agents. Method and Materials:It was a randomized parallel control single blind study consisting of total of 36 cases, 12 cases each of melasma, photo melanosis and post acne pigmentation within age group 20-50 years having fitzpatrick’s skin type4. Woods lamp examination was done to confirm the type of melasma.Patients with keloidal tendency, active herpes infection or past history of hypersensitivity to salicylic acid, trichloroaceticand glycolic acid as well aspatients on systemic isotretinoin were excluded.Clinical photographs at the beginning of therapy and then serially, were taken to assess the clinical response. Prior to application a written informed consent was obtained. A post auricular test peel was performed. Patients were divided into 3 groups, containing 12 patients each of melasma, photomelanosis and post acnepigmentation.All the three peels SA peel 20% (done once in 2 weeks), GA peel 50% (done once in 3 weeks) and TCA 15% (done once in 3 weeks) were used with total six settings for each patient. Before application of peel patients were counseled to wash the face with soap and water. Then face was dried and cleaned with spirit and acetone to remove all cutaneous oils. GA, TCA, SA were applied with cotton buds/gauze withmild strokes. After a contact period off 5-10mins neutralization was done with cold water. Post peel topical sunscreen application was mandatory. MASI was used pre and post treatment to assess melasma. Investigator’s global improvement scale- overall hyperpigmentation (4-significant, 3-moderate, 2-mild, 1-minimal, 0-no change ) and Patient’s satisfaction grading scale (>70%- excellent response, 50-70%- good response, <50%- average response) was used to assess improvement in all the three facial melanosis.Results:In our study of 12 patients of melasma, 4 (33.33%)patients showed excellent results;3 (25%) with GAand 1(8.33%) of TCA.Good response was seen in 4 (33.33%) patients;1(8.33%) each for GA & SA and 2(16.66%) for TCA.Poor response was seen in 4(33.33%) patients;1(8.33%) for TCA and 3 (25%) for SA.Of 12 patients of photomelanosis, excellent resultswas seen in 3(25%)patients of TCA. Good response was seen in 4 (33.33%) patients, 1(8.33%) each of TCA &SA and 2(16.66%) of GA.Poor responsewas seen in 5(41.66%) patients;3 (25%) for SA and 2(16.66%) of GA.Of 12 patients of post acne pigmentation, excellent responsein 3 (25%) patients;2(16.66%) of SA and 1(8.33%) of TCA.Good responsewas seen in 5(41.66%) patients;2(16.66%) of SA and GA and1(8.33%) of TCA.Poor response was seen in 4 (33.33%) patients; 2 (16.66%) for SA and TCA both. No major side effects in the form of scarring or persistant pigmentation was seen. Transient blackening of skin with burning sensation was seen in cases treated with TCA and SA. Post procedural itching and redness was noted with GA peel. Conclusion- In our study GA(50%),TCA(15%) & SA(20%) peels showed excellent response in melasma, photomelanosis and post-acne pigmentation respectively.All the 3 peeling agents were well tolerated without any significant side-effects in the above specified concentrations.

Keywords: facial melanosis, gycolic acid, salicylic acid, trichloroacetic acid

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Authors: M. Taleb, G. Tail, F. Z. Kara, B. Djedouani T. Moussa

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Necrophagous insects usually colonize cadavers within a short time after death. However, they are influenced by weather conditions, and their distribution and activity vary according to different time scales, which can affect the post-mortem interval (PMI) estimation. As no data have been published in Algeria on necrophagous insects visiting corpses, two field surveys were conducted in July 2012 and March 2013 at the National Institute for Criminalistics and Criminology (INCC) using rabbit carcasses (Oryctolagus cuniculus L.). The trials were designed to identify the necrophagous Diptera fauna of Algiers, Algeria and examine their variations according to environmental variables. Four hundred and eighteen Diptera adults belonging to five families were captured during this study. The species which were identified on human corpses in different regions of Algeria were also observed on the rabbit carcasses. Although seasonal variations of the species were observed, their abundance did not significantly vary between the two seasons. In addition to seasonal effects, the ambient temperature, the wind speed, and precipitation affect the number of trapped flies. These conclusions highlight the necessity of considering the environmental factors at a scene to estimate the post-mortem interval accurately. It is hoped that these findings provide basic information regarding the necrophagous Diptera fauna of Algeria.

Keywords: forensic entomology, necrophagous diptera, post-mortem interval, abiotic factors, Algeria

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Authors: Hamza Javar Magnier, Leslie V. Woodcock

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We report extensive molecular dynamics (MD) computational investigations into the thermodynamic description of supercritical properties for a model fluid that is the simplest realistic representation of atoms or molecules. The pair potential is a hard-sphere repulsion of diameter σ with a very short attraction of length λσ. When λ = 1.005 the range is so short that the model atoms are referred to as “adhesive spheres”. Molecular dimers, trimers …etc. up to large clusters, or droplets, of many adhesive-sphere atoms are unambiguously defined. This then defines percolation transitions at the molecular level that bound the existence of gas and liquid phases at supercritical temperatures, and which define the existence of a supercritical mesophase. Both liquid and gas phases are seen to terminate at the loci of percolation transitions, and below a second characteristic temperature (Tc2) are separated by the supercritical mesophase. An analysis of the distribution of clusters in gas, meso- and liquid phases confirms the colloidal nature of this mesophase. The general phase behaviour is compared with both experimental properties of the water-steam supercritical region and also with formally exact cluster theory of Mayer and Mayer. Both are found to be consistent with the present findings that in this system the supercritical mesophase narrows in density with increasing T > Tc and terminates at a higher Tc2 at a confluence of the primary percolation loci. The expended plot of the MD data points in the mesophase of 7 critical and supercritical isotherms in highlight this narrowing in density of the linear-slope region of the mesophase as temperature is increased above the critical. This linearity in the mesophase implies the existence of a linear combination rule between gas and liquid which is an extension of the Lever rule in the subcritical region, and can be used to obtain critical parameters without resorting to experimental data in the two-phase region. Using this combination rule, the calculated critical parameters Tc = 0.2007 and Pc = 0.0278 are found be agree with the values found by of Largo and coworkers. The properties of this supercritical mesophase are shown to be consistent with an alternative description of the phenomenon of critical opalescence seen in the supercritical region of both molecular and colloidal-protein supercritical fluids.

Keywords: critical opalescence, supercritical, square-well, percolation transition, critical parameters.

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Authors: Nada A. El-Shahaw, Anas A.Salem, M. Kobeisy, Hoda M. Shabaan

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Reactive oxygen species (ROS) is collective term both oxygen radical, such superoxide (O₂•), hydroxyl(OH•), peroxyl (RO₂), and hydroperoxyl (HO₂•), and certain non-radical oxidizing agents, such as hydrogen peroxide (H₂O₂), hypochlorous acid (HOCL), and ozone (O₃), that can be convert easily to radical. The importance of antioxidants is shown here punicalagin. Punicalagin is preventing the harmful effect of (ROS) in all cells, specially gonadal cells. So, the aim of study was to investigate effects of punicalagin (PL) on maternal live body weight (MLBW), number of services/conception (NS), conception rate (CR), gestation length (GL), kindling rate (KR), total litter size (TLS), live litter size (LLS), kit weight (KW), progesterone (P4) and estradiol-17 (E2) concentrations at 1st and 2nd pregnancy of young does. A total of 28 healthy virgin does (6 months old) were divided into 2 equal groups. Group I, each doe, was injected IM with 100 ug PL twice/week pre-mating and one time 3 days post-mating. Group II, each doe was injected IM with sterilized water (control). Blood samples were taken at pre-mating, mating, post-mating, throughout pregnancy, and immediately post-kindling for assaying P4 and E2. All does were naturally mated with fertile bucks. Results revealed that PL displayed their significant impacts on MLBW, NS/conception, CR, GL, KR, TLS, LLS, KWs (birth and weaning), P4 and E2 concentrations either at 1ˢᵗ/2ⁿᵈ pregnancy or both of them. Conclusively, PL improved pregnancy outcomes of young do particularly at 2ⁿᵈ pregnancy and could be recommended in rabbit's farms.

Keywords: punicalagin, pregnancy, estradiol-17β, progesterone, does

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students. 

Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant

Procedia PDF Downloads 125

Authors: Beloulou Mohamed Lamine, Bouhouf Attef, Meliani Walid, Sellami Dalila, Lamara Abdelhak

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Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with post-surgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariate analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature or component, particularly in surgeries that are more prone to chronicization.

Keywords: chronic postsurgical pain, postsurgical chronic neuropathic pain, regional anesthesia and analgesia techniques (RAAT), neuropathic pain score dn2, preventive impact

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Authors: Emilie Fort

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Two major pitfalls emerge at the intersection of gender and peacebuilding literature: the comprehension of women as a homogeneous category and a focus on women's participation in formal peace processes and state structures. However, women belong (and identify) to distinct ethnic, religious, or social groups, and the variety of their social location impacts their ability to mobilize, to participate in peace processes as well as the way they envision peace. This study is based on interviews conducted (remotely) with women activists from the post-Yugoslav area. It shows that women's economic empowerment and education are central issues that must be addressed for women political participation being effective. This has implications for peace projects –their priorities, scales of implementation, etc.– and the allocation of civil society’s funds.

Keywords: ex-Yugoslavia, gender-based issues, peacebuilding, women activism

Procedia PDF Downloads 195

Authors: Jianan Li, Lusen Shi, Haiqiao Du, Wei Chen, Qian Wang, Shuoshuo Kang, Shiming Yang

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Background: Follow-up of cochlear implant effectiveness is mainly focused on 3 years postoperatively, and studies with more than 5 years of observation are rare, especially for local Chinese brands. Objectives: Nurotron (Chinese domestic cochlear implant brand) CI recipients who participated in the clinical trial in 2009 were followed-up for 10 years prospectively, providing data to guide doctors and patients. Material and Methods: From December 2009 to April 2010, 57 subjects underwent Nurotron Venus CI surgery at multiple centers and were continued to be followed up and assessed at 1, 2, 3, 4, 5, and 10 years after switching on. Results: All recipients were successfully implanted with CIs with no difficulty in subsequent use, with one reported case of re-implantation 9 years after implantation. The aided hearing thresholds were significantly improved one month after switching on (p<0.0001) and remained stable afterward for 10 years. Speech recognition scores were significantly higher than pre-operative results (p<0.05) and continued to improve till 3 years after switching on. At 10 years of post-operation, most subjects had improved QOL scores in most sub-items. Conclusions and Significance: Nurotron Venus CI System provides long-term, stable results in hearing speech assistance capabilities and can improve the quality of life of CI recipients.

Keywords: cochlear implantation, hearing loss, post lingual, follow up

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Authors: Kirill D. Kapustin, Mikhail B. Krasilnikov, Anatoly A. Kudryavtsev

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Physical formation mechanisms of differential electron fluxes is high pressure positive column gas discharge are discussed. It is shown that the spatial differential fluxes of the electrons are directed both inward and outward depending on the energy relaxation law. In some cases the direction of energy differential flux at intermediate energies (5-10eV) in whole volume, except region near the wall, appeared to be down directed, so electron in this region dissipate more energy than gain from axial electric field. Paradoxical behaviour of electron flux in spatial-energy space is presented.

Keywords: plasma kinetics, electron distribution function, excitation and radiation rates, local and nonlocal EDF

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Authors: Shawna Staud, Mary Kaye Scaramucci

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Objective: Rubber cup polishing has been a traditional method of preventative therapy in dental hygiene treatment. Newer methods such as air polishing have changed the way dental hygiene care is provided, yet this technique has not been embraced by students in the program nor by practitioners in the workforce. Students entering the workforce tend to follow office protocol and are limited in confidence to introduce technologies learned in the curriculum. This project was designed to help students gain confidence in newer skills and encourage private practice settings to adopt newer technologies for patient care. Our program recently introduced air polishing earlier in the program before the rubber cup technique to determine if students would embrace the technology to become leading-edge professionals when they enter the marketplace. Methods: The class of 2022 was taught the traditional method of polishing in the first-year curriculum and air polishing in the second-year curriculum. The class of 2023 will be taught the air polishing method in the first-year curriculum and the traditional method of polishing in the second-year curriculum. Pre- and post-graduation survey data will be collected from both cohorts. Descriptive statistics and pre and post-paired t-tests with alpha set at .05 to compare pre and post-survey results will be used to assess data. Results: This study is currently in progress, with a completion date of October 2023. The class of 2022 completed the pre-graduation survey in the spring of 2022. The post-gradation survey will be sent out in October 2022. The class of 2023 cohort will be surveyed in the spring of 2023 and October 2023. Conclusion: Our hypothesis is students who are taught air polishing first will be more inclined to adopt that skill in private practice, thereby embracing newer technology and improving oral health care.

Keywords: luggage handling system at world’s largest pilgrimage center

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Authors: Placide Poba-Nzaou, Anicet Tchibozo, Malatsi Galani, Ali Etkkali, Erwin Halim

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Artificial intelligence (AI) is a general-purpose technology that is transforming many industries, working life and society by stimulating economic growth and innovation. Despite the huge potential of benefits to be generated, the adoption of AI varies from one organization to another, from one region to another, and from one industry to another, due in part to obstacles that can inhibit an organization or organizations located in a specific geographic region or operating in a specific industry from adopting AI technology. In this context, these obstacles and their implications for AI adoption from the perspective of configurational theory is important for at least three reasons: (1) understanding these obstacles is the first step in enabling policymakers and providers to make an informed decision in stimulating AI adoption (2) most studies have investigating obstacles or challenges of AI adoption in isolation with linear assumptions while configurational theory offers a holistic and multifaceted way of investigating the intricate interactions between perceived obstacles and barriers helping to assess their synergetic combination while holding assumptions of non-linearity leading to insights that would otherwise be out of the scope of studies investigating these obstacles in isolation. This study aims to pursue two objectives: (1) characterize organizations by uncovering the typical profiles of combinations of 15 internal and external obstacles that may prevent organizations from adopting AI technology, (2) assess the variation in terms of intensity of AI adoption associated with each configuration. We used data from a survey of AI adoption by organizations conducted throughout the EU27, Norway, Iceland and the UK (N=7549). Cluster analysis and discriminant analysis help uncover configurations of organizations based on the 15 obstacles, including eight external and seven internal. Second, we compared the clusters according to AI adoption intensity using an analysis of variance (ANOVA) and a Tamhane T2 post hoc test. The study uncovers three strongly separated clusters of organizations based on perceived obstacles to AI adoption. The clusters are labeled according to their magnitude of perceived obstacles to AI adoption: (1) Cluster I – High Level of perceived obstacles (N = 2449, 32.4%)(2) Cluster II – Low Level of perceived obstacles (N =1879, 24.9%) (3) Cluster III – Moderate Level of perceived obstacles (N =3221, 42.7%). The proposed taxonomy goes beyond the normative understanding of perceived obstacles to AI adoption and associated implications: it provides a well-structured and parsimonious lens that is useful for policymakers, AI technology providers, and researchers. Surprisingly, the ANOVAs revealed a “high level of perceived obstacles” cluster associated with a significantly high intensity of AI adoption.

Keywords: Artificial intelligence (AI), obstacles, adoption, taxonomy.

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Authors: Surjeet Bakshi, Surabhi Sharma

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Objective: To assess the impact of educational sessions by reputed regional faculties on knowledge of primary care physicians on evidence based diabetes management methods and practice. Study Design: Retrospective pre-post intervention study. Methodology: Nine cities in Kerala from August to October, 2012 were selected for the study. 125 MBBS doctors participated in the study. 11 regional faculties provided six educational sessions throughout the period. Validated questionnaires were used to evaluate the knowledge of the participants on evidence based diabetes management methods before and after the intervention. Results: The mean score on pre-test was 8 and the mean score on post-test was 9. A paired t-test was conducted on participant’s pre- and post test score and the results were statistically significant (p<0.001). Conclusion: Even though the general attitude to and level of knowledge of diabetes management is good among the primary care physicians in India, there do exist some knowledge gaps which might influence their future practices when it comes to counselling and information on diabetes management methods. In the present study, the performance and awareness level of the participants have expressively improved among primary care physicians. There is a significant improvement in the test score and the training conducted. It seems that if such study programmes are included in the students study programme, it will give higher score in the knowledge and attitude towards diabetes management.

Keywords: diabetes, management, primary care physicians, evidence base, improvement score, knowledge

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Authors: Michael A. Tabug, Arvin C. Diesmos

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The foraging ecology of the Philippine endemic Draco spilopterus was studied through a combination of in-situ field observations and laboratory examinations of specimens of the species. A total of four populations of the species were studied across the Luzon Biogeographic Region between June 2017 and March 2019. Of the 59 lizards captured, gut contents of 54 individuals were studied. A total of 2933 food items were sorted into seven types, such as Formicidae (ants) (96%), Araneae (spiders) (0.034%), Coleoptera (beetles) (0.579%), Hemiptera (scale insects) (0.102%), Isoptera (termites) (2.796%), Lepidoptera (larvae) (0.307%), and Diplopoda (millipede) (0.102%). Diet analysis revealed that D. spilopterus fed mainly on insect arthropods and were dominated by ants (Formicidae). Of the four populations studied, lizards consumed a relatively high proportion of ants (96%), which strongly implies that D. spilopterus is a specialist predator and a sit-and-wait active forager. The observed feeding activities of D. spilopterus also show that it is diurnal forager and actively hunts for prey from 0830 hr to 1658 hr, with decreasing activity during midday. Draco spilopterus lizards were also observed to use a wide spectrum of perch heights while foraging, regardless of the dimension of trees.

Keywords: ant specialists, diet analysis, flying lizards, foraging ecology, Luzon Biogeographic Region

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Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

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Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

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Authors: N. Saranya

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The difference in characteristic behavior of clay minerals for different electrolyte solution is dictated by the corresponding variation occurring at its diffused double layer thickness (DDL). The diffused double layer of clay mineral has two distinct regions; the inner region is termed as ‘Stern layer’ where ions are strongly attached to the clay surface. In the outer region, the ions are not strongly bonded with the clay surface, and this region is termed as ‘diffuse layer’. Within the diffuse layer, there is a plane that forms a boundary between the moving ions and the ions attached to the clay surface, which is termed as slipping or shear plane, and the potential of this plane is defined as zeta potential (ζ). Therefore, the variation in diffused double layer properties of clay mineral for different electrolyte solutions can be modeled if the corresponding variation in surface charge, surface potential, and zeta potential are computed. In view of this, the present study has attempted to characterize the diffused double layer properties of three different clay minerals interacting with different pore fluids by measuring the corresponding variation in surface charge, surface potential, and zeta potential. Further, the obtained variation in the diffused double layer property is compared with the Gouy-Chapman model, which is the widely accepted theoretical model to characterize the diffused double layer properties of clay minerals.

Keywords: DDL, surface charge, surface potential, zeta potential

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Authors: Kaoutar Chbihi, Aziza Menouni, Imane Berni, Tarik Abchouch, Samir El Jaafari

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The unpredictability and ambiguity of a pandemic, combined with the economic impact, sedentary lifestyle, and increased living cost, have the potential to seriously raise the risk of mental health issues among the population. Therefore, this study had the aim to assess the magnitude of mental health outcomes and risk factors among the general population in Morocco in times of the Covid-19 pandemic. This study consisted of a cross-sectional design and was survey-based and region-stratified by collecting demographic data and mental health measurements from 523 participants. The degree of depression, anxiety, and insomnia symptoms were assessed by using the 9-item Patient Health Questionnaire and the 7-items Generalized Anxiety Disorder. The survey was completed by 523 individuals. Results showed that 67.9% were women, and 58.6% were aged 18-30 years. 49% of participants reported depression issues, while 39.8% experienced anxiety. Being a married woman with children was associated with severe symptoms of depression and anxiety. Finally, our findings reported a significant mental health burden among the general population of Morocco, which needs to be tackled by specific co-created interventions and adapted strategies in order to prevent impacts on public health.

Keywords: anxiety, COVID-19, depression, mental health, Morocco, pandemic

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Authors: Garima Joshi, Ashima N. Wadhawan

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Neuropsychology in India is a fairly new field, having started only four decades back. Neuropsychology has come a long way since the establishment of the first department, from using western batteries for assessing patients to the development of highly reliable indigenous tools for assessing neuropsychological functioning. Clinical neuropsychology has risen as a discipline in the field of assessing and rehabilitating patients with various neurological conditions such as Traumatic Brain Injury, Stroke, Mild Cognitive Impairment, Alzheimer’s, Schizophrenia and other disorders with cognitive decline. The current review attempts to assimilate the history of the discipline in India, along with the current developments and future direction of the field and highlights the pursuit and undertakings of the scientists to provide culturally appropriate services, in terms of assessment and rehabilitation, to the Indian population.

Keywords: clinical neuropsychology, cognitive assessment, cognitive rehabilitation, neuropsychological test batteries in India

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Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

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Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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Authors: Layaly Ayoub, Mariana Ribeiro

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Introduction: Breast cancer is currently considered the leading cause of cancer-related deaths among women in Brazil. Mastectomy, essential in this treatment, often necessitates subsequent breast reconstruction to restore physical appearance and aid in the emotional and psychological recovery of patients. The choice between immediate or delayed reconstruction is influenced by factors such as the type and stage of cancer, as well as the patient's overall health. The decision between autologous breast reconstruction or implant-based reconstruction requires a detailed analysis of individual conditions and needs. Objectives: This study analyzes the techniques and indications used in post-mastectomy breast reconstruction. Methodology: Literature review conducted in the PubMed and SciELO databases, focusing on articles that met the inclusion and exclusion criteria and descriptors. Results: After mastectomy, breast reconstruction is commonly performed. It is necessary to determine the type of technique to be used in each case depending on the specific characteristics of each patient. The tissue expander technique is indicated for patients with sufficient skin and tissue post-mastectomy, who do not require additional radiotherapy, and who opt for a less complex surgery with a shorter recovery time. This procedure promotes the gradual expansion of soft tissues where the definitive implant will be placed. Both temporary and permanent expanders offer flexibility, allowing for adjustment in the expander size until the desired volume is reached, enabling the skin and tissues to adapt to the breast implant area. Conversely, autologous reconstruction is indicated for patients who will undergo radiotherapy, have insufficient tissue, and prefer a more natural solution. This technique uses the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi muscle flap, the gluteal flap, and local muscle flaps to shape a new breast, potentially combined with a breast implant. Conclusion: In this context, it is essential to conduct a thorough evaluation regarding the technique to be applied, as both have their benefits and challenges.

Keywords: indications, post-mastectomy, breast reconstruction, techniques

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Authors: Abasse Kamarchou, Ahmed Abdelhafid Bebba, Ali Douadi

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The objective of this work is the preparation of an activated carbon from waste date palm from El Oued region, namely the date stones and its use in the treatment of wastewater in this region. The study of the characteristics of this coal has the following results: specific surface 125.86 m2 / g, pore volume 0.039 cm3 / g, pore diameter of 16.25 microns, surface micropores 92.28 m2 / g, the outer surface 33,57 m2 /g, methylene blue number of 13.6 mg / g, iodine number 735.2 mg /g, the functional groups are the number of 4.10-2 mol / g. The optimum conditions for pH, stirring speed, initial concentration, contact time were determined. For organic pollutants, the best conditions are: pH > 8 and pH < 5, a contact time of 5 minutes and an agitation rate of 200 - 300 rpm.

Keywords: date palm, activated carbon, wastewater, El-Oued

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Authors: Rema Vazhappilly, Tapas Das

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Oleic acid is a cis unsaturated fatty acid and is known to be a partially essential fatty acid due to its limited endogenous synthesis during pregnancy and lactation. Previous studies have demonstrated the role of oleic acid in neuronal differentiation and brain phospholipid synthesis. These evidences indicate a major role for oleic acid in learning and memory. Interestingly, oleic acid has been shown to enhance hippocampal long term potentiation (LTP), the physiological correlate of long term synaptic plasticity. However the effect of oleic acid on short term synaptic plasticity has not been investigated. Short term potentiation (STP) is the physiological correlate of short term synaptic plasticity which is the key underlying molecular mechanism of short term memory and neuronal information processing. STP in the hippocampal CA1 region has been known to require the activation of N-methyl-D-aspartate receptors (NMDARs). The NMDAR dependent hippocampal STP as a potential mechanism for short term memory has been a subject of intense interest for the past few years. Therefore in the present study the effect of oleic acid on NMDAR dependent hippocampal STP was determined in mouse hippocampal slices (in vitro) using Multi-electrode array system. STP was induced by weak tetanic Stimulation (one train of 100 Hz stimulations for 0.1s) of the Schaffer collaterals of CA1 region of the hippocampus in slices treated with different concentrations of oleic acid in presence or absence of NMDAR antagonist D-AP5 (30 µM) . Oleic acid at 20 (mean increase in fEPSP amplitude = ~135 % Vs. Control = 100%; P<0.001) and 30 µM (mean increase in fEPSP amplitude = ~ 280% Vs. Control = 100%); P<0.001) significantly enhanced the STP following weak tetanic stimulation. Lower oleic acid concentrations at 10 µM did not modify the hippocampal STP induced by weak tetanic stimulation. The hippocampal STP induced by weak tetanic stimulation was completely blocked by the NMDA receptor antagonist D-AP5 (30µM) in both oleic acid and control treated hippocampal slices. This lead to the conclusion that the hippocampal STP elicited by weak tetanic stimulation and enhanced by oleic acid was NMDAR dependent. Together these findings suggest that oleic acid may enhance the short term memory and neuronal information processing through the modulation of NMDAR dependent hippocampal short-term synaptic plasticity. In conclusion this study suggests the possible role of oleic acid to prevent the short term memory loss and impaired neuronal function throughout development.

Keywords: oleic acid, short-term potentiation, memory, field excitatory post synaptic potentials, NMDA receptor

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Authors: Bashar Tarawneh, Yasser Hakam

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Rapid Impact Compaction (RIC) is a modern dynamic compaction device mainly used to compact sandy soils, where silt and clay contents are low. The device uses the piling hammer technology to increase the bearing capacity of soils through controlled impacts. The RIC device uses "controlled impact compaction" of the ground using a 9-ton hammer dropped from the height between 0.3 m to 1.2 m onto a 1.5 m diameter steel patent foot. The delivered energy is about 26,487 to 105,948 Joules per drop. To evaluate the performance of this technique, three project sites in the United Arab Emirates were improved using RIC. In those sites, a loose to very loose fine to medium sand was encountered at a depth ranging from 1.0m to 4.0m below the ground level. To evaluate the performance of the RIC, Cone Penetration Tests (CPT) were carried out before and after improvement. Also, load tests were carried out post-RIC work to assess the settlements and bearing capacity. The soil was improved to a depth of about 5.0m below the ground level depending on the CPT friction ratio (the ratio between sleeve friction and tip resistance). CPT tip resistance was significantly increased post ground improvement work. Load tests showed enhancement in the soil bearing capacity and reduction in the potential settlements. This study demonstrates the successful application of the RIC for middle-deep improvement and compaction of the ground. Foundation design criteria were achieved in all site post-RIC work.

Keywords: compaction, RIC, ground improvement, CPT

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Authors: Madeleine Cox

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Objective: discussion of diagnosis of vernix caseosa peritonitis, recovery and subsequent caesarean seciton Case: 30 year old G4P1 presented in labour at 40 weeks, planning a vaginal birth afterprevious caesarean section. She underwent an emergency caesarean section due to concerns for fetal wellbeing on CTG. She was found to have a thin lower segment with a very small area of dehiscence centrally. The operation was uncomplicated, and she recovered and went home 2 days later. She then represented to the emergency department day 6 post partum feeling very unwell, with significant abdominal pain, tachycardia as well as urinary retention. Raised white cell count of 13.7 with neutrophils of 11.64, CRP of 153. An abdominal ultrasound was poorly tolerated by the patient and did not aide in the diagnosis. Chest and abdominal xray were normal. She underwent a CT chest and abdomen, which found a small volume of free fluid with no apparent collection. Given no obvious cause of her symptoms were found and the patient did not improve, she had a repeat CT 2 days later, which showed progression of free fluid. A diagnostic laparoscopy was performed with general surgeons, which reveled turbid fluid, an inflamed appendix which was removed. The patient improved remarkably post operatively. The histology showed periappendicitis with acute appendicitis with marked serosal inflammatory reaction to vernix caseosa. Following this, the patient went on to recover well. 4 years later, the patient was booked for an elective caesarean section, on entry into the abdomen, there were very minimal adhesions, and the surgery and her subsequent recovery was uncomplicated. Discussion: this case represents the diagnostic dilemma of a patient who presents unwell without a clear cause. In this circumstance, multiple modes of imaging did not aide in her diagnosis, and so she underwent diagnostic surgery. It is important to evaluate if a patient is or is not responding to the typical causes of post operative pain and adjust management accordingly. A multiteam approach can help to provide a diagnosis for these patients. Conclusion: Vernix caseosa peritonitis is a rare cause of acute abdomen post partum. There are few reports in the literature of the initial presentation and no reports on the possible effects on future pregnancies. This patient did not have any complications in her following pregnancy or delivery secondary to her diagnosis of vernix caseosa peritonitis. This may assist in counselling other women who have had this uncommon diagnosis.

Keywords: peritonitis, obstetrics, caesarean section, pain

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Authors: Kinneret Segal

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The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world, and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives, has not been sufficiently explored. The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life and organizational commitment among midwifery nurses in Israeli hospitals. 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms and organizational commitment, predicted satisfaction from compassion. Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: traumatic experirnces, midwives, quality of life, burnout, organizational commitment, personal resilience

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Authors: Wenqian Bai

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Background: In response to the post-pandemic directives of Xi Jinping concerning the new era of ecological civilization, China has embarked on ecological restoration projects across its territorial spaces. This initiative faces challenges such as complex evaluation metrics and subpar informatization standards. Methodology: This research focuses on Mianzhu City, Sichuan Province, to assess its resource and environmental carrying capacities and the appropriateness of land use for development from ecological, agricultural, and urban perspectives. The study incorporates a range of spatial data to evaluate factors like ecosystem services (including water conservation, soil retention, and biodiversity), ecological vulnerability (addressing issues like soil erosion and desertification), and resilience. Utilizing the Minimum Cumulative Resistance model along with the ‘Three Zones and Three Lines’ strategy, the research maps out ecological corridors and significant ecological networks. These frameworks support the ecological restoration and environmental enhancement of the area. Results: The study identifies critical ecological zones in Mianzhu City's northwestern region, highlighting areas essential for protection and particularly crucial for water conservation. The southeastern region is categorized as a generally protected ecological zone with respective ratings for water conservation functionality and ecosystem resilience. The research also explores the spatial challenges of three ecological functions and underscores the substantial impact of human activities, such as mining and agricultural expansion, on the ecological baseline. The proposed spatial arrangement for ecological restoration, termed ‘One Mountain, One Belt, Four Rivers, Five Zones, and Multiple Corridors’, strategically divides the city into eight major restoration zones, each with specific tasks and projects. Conclusion: With its significant ‘mountain-plain’ geography, Mianzhu City acts as a crucial ecological buffer for the Yangtze River's upper reaches. Future development should focus on enhancing ecological corridors in agriculture and urban areas, controlling soil erosion, and converting farmlands back to forests and grasslands to foster ecosystem rehabilitation.

Keywords: ecological restoration, resource and environmental carrying capacity, land development suitability, ecosystem services, ecological vulnerability, ecological networks

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Authors: Mrunmayee Das

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This study aims to explore the film 'Pyasa' directed by actor-director Guru Dutt, filmed during the 1950’s golden age of Hindi cinema. 'Pyasa' was filmed after a decade of India being a new nation and narrates the world-view of a poet dressed in western ideals, tasting modernity, uprooted from his familial and social moorings causing friction of being between survival and self- expression. The research is based on literature review to study the attitudes, particularly the post-colonial, informing the film. In terms of the structure, the relational study of the film and the historical background of that time came first. Further explorations deal with the use of image making, dialogue, and poetry in the form of songs facilitating the central theme of the human plight of poverty, not of material but of thought. The literature review establishes Dutt’s style of expressing melodic melodrama through a dance between light and shadow majorly in the form of song sequences signifying the greys of the society. It was found in this research that melodrama is created by the changing contrasts and use of close-ups. The song sequences convey the tensions of being a contemporary liberal educated youth and having to deal with the societal-ills of this world, which highlights the theme of compulsion towards self-destruction. It is concluded that Dutt’s 'Pyasa' is a autobiographical commentary on the state of a nation doing away with a borrowed identity and refashioning its own.

Keywords: cinema, Guru Dutt, post-colonial India, self-expression

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